Protected Health Information (PHI) Security

Protecting PHI is essential in today’s healthcare landscape. A Protected Health Information (PHI) breach is any situation where PHI is used or disclosed in a way that violates HIPAA regulations, compromising its privacy or security. Essentially, it’s unauthorized access, use, or disclosure of PHI that puts the information at risk.

Types of PHI Breaches:

• Secure faxes: Sometimes, secure fax transmissions can include the wrong patient charts or unrequested records. Fax numbers should be verified prior to sending to ensure the correct recipient.
• Unencrypted emails: All emails containing PHI must be encrypted to ensure protection of PHI.
• Unintentional breaches: These occur when there is unintentional access to PHI in good faith while performing one’s job, and such access does not result in further impermissible use or disclosure.
• Inadvertent disclosures: These happen when PHI is unintentionally disclosed by a person authorized to access PHI at a covered entity or business associate to another person not authorized to receive it.
• Improperly disclosed information: This includes situations where PHI is improperly disclosed, but the covered entity or business associate believes in good faith that the recipient of the unauthorized information would not be able to retain the information. This also includes improper maintenance of records.
• Unauthorized review of healthcare records: Accessing the health records of patients for reasons other than those permitted by the HIPAA Privacy Rule is a violation of patient privacy.

KDJ Consultants uses a secure fax server for all fax transmissions. This ensures that even if someone faxes us incorrect patient data, it is always secure. We verify all fax numbers prior to transmission to ensure faxes reach the intended recipient. The availability of a secure portal provides another secure option for providers and clients to drop records to KDJ Consultants if unable to fax. We take the security of all sensitive information seriously.

KDJ Consultants takes pride in protecting client data through extensive network security, data encryption, strong security policies and procedures, and a team committed to following those procedures.

~Melissa Buchanan

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This Month – Focus on Prediabetes

November is National Diabetes Month, a time when communities across the country team up to bring attention to diabetes. This year’s focus is on prediabetes and preventing diabetes. Prediabetes is a serious health condition where your blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. 

According to the CDC, more than 1 in 3 U.S. adults have prediabetes—that’s 88 million people—but the majority of people don’t know they have it.

Diabetes Can Be Managed

Here are some tips to help manage prediabetes and prevent diabetes.

·         Take small steps. Making changes to your lifestyle and daily habits can be hard, but you don’t have to change everything at once. It is okay to start small. Remember that setbacks are normal and do not mean you have failed—the key is to get back on track as soon as you can.

·         Move more. Limit time spent sitting and try to get at least 30 minutes of physical activity, 5 days a week. Start slowly by breaking it up throughout the day.

·         Choose healthier foods and drinks most of the time. Pick foods that are high in fiber and low in fat and sugar. Build a plate that includes a balance of vegetables, protein, and carbohydrates. Drink water instead of sweetened drinks.

·         Lose weight, track it, and keep it off. You may be able to prevent or delay diabetes by losing 5 to 7 percent of your starting weight.

·         Seek support. It is possible to reverse prediabetes. Making a plan, tracking your progress, and getting support from your health care professional and loved ones can help you make the necessary lifestyle changes.

·         Stay up to date on vaccinations. The COVID-19 (booster shot, if eligible) and flu vaccines are especially important for people who may be more likely to get very sick from COVID-19 or the flu, such as people with diabetes.

Conclusion

The good news is that by making small healthy lifestyle changes, it is possible to prevent type 2 diabetes and even reverse your prediabetes.

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The Secret of Successful EMR Reviews

At the end of the day, quality EMR reviews boil down to one thing, accurately depicting what happened in that hospital room, emergency center, or outpatient clinic.

Whether you are trying to control costs upfront or manage claims on the backend, accurate and thorough EMR reviews are essential. For those companies, the challenge is in finding a qualified team that not only has the history and experience of reading those electronic medical records, but has the means and understanding to catalog that data into usable data that can be reviewed my medical and accounting teams.

Registered Nurses Are Essential

While we already think of RN’s as essential workers, a skilled registered nurse is also essential in reading and interpreting medical charts. RN’s that have been on the front lines, often for decades, are uniquely qualified to analyze and abstract the data from charts that are often hurriedly prepared. This first step, of taking scanned and/or digital chart data and inputting into a usable data structure is crucial to achieving thorough EMR reviews, and shouldn’t be left to lesser trained individuals or offshore data crunchers.

Quality Reviews = Big Data

We often hear the term Big Data thrown around like it’s a bad thing. It doesn’t have to be. In fact, when that data consists of tens of thousands of quality EMR reviews, it’s quite the opposite. When that data is compiled into a digestible form by data abstraction professionals, it can be analyzed ad nauseum to gauge the effectiveness of diabetes programs, cancer screening programs, weight-loss initiatives and more.

With effective and complete analysis of your EMR reviews, companies can make better decisions to improve patient care, and their bottom line. If you are looking for a team to take you to the next level, consider the highly experienced and qualified team at KDJ Consultants.

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What is HEDIS?

HEDIS® is the common acronym for Healthcare Effectiveness Data and Information Set, and is one of the most widely used tools available to report on the effectiveness of healthcare practices and procedures. As stated by CMS.gov;

“HEDIS® is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance.“

HEDIS® was created by the National Committee for Quality Assurance (NCQA) to develop to help evaluate the quality of care provided by Special Needs Plans. Originally designed to help compare health plans, HEDIS® data is annually used to track year-to-year performance.

HEDIS® Measures

Measuring the effectiveness of healthcare practices manifests itself in the form of HEDIS® Measures. A few common measures might include:

• Controlling High Blood Pressure
• Glycemic Status Assessment for Patients with Diabetes
• Cervical Cancer Screening
• Statin Therapy for Patients With Cardiovascular Disease and Diabetes
• Use of High-Risk Medications in Older Adults
• Fall Risk Management

Overall, there are roughly 90 established measures sanctioned by NCQA. HEDIS® measures vary year to year and changes as the need to monitor effectiveness changes.

What Is The Purpose of HEDIS®

HEDIS® performance data helps doctors, hospitals, and insurance providers achieve a high level of care using the most efficient practices and procedures. Using this valuable data service providers can identify opportunities for improvement in their process stack. By laying out specific quality measures, providers can monitor the success of any quality improvement programs they initiate. Successes in these initiatives can be tracked, allowing a pivot to better practices if the expected measure of success is not realized.

The ultimate value of HEDIS® measures is to hold each management tier accountable for effective patient care while carefully monitoring costs.

KDJ Consultants’ stellar track record in managing HEDIS® initiatives means you can improve your patient care and improve your best practices. Contact KDJ Consultants today for a consultation.

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